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Topics of The Times; 1.5 Bureaucrats per Patient

Remember the old jokes about the Agriculture Department, playing off the fact that as the number of American farmers declined, the number of bureaucrats kept soaring? One day, the story goes, an official was spotted crying in the hallway. "What's the matter?" he was asked. "My farmer just died," he replied.

Well, something very like that is going on in hospitals right now. A paper in The New England Journal of Medicine reports that an astonishing 25 percent of the average American hospital's spending in 1990 went for administration. "In many hospitals," the study found, "as the number of patients declined, the number of bureaucrats increased to battle with competing hospitals over market share and with insurers over payment."

In 1968, for example, American hospitals employed 435,000 managers and clerks on an average day to assist in the care of 1,378,000 patients. In 1990, the number of patients had fallen to 853,000 a day, but the number of administrators and clerks had risen to 1,222,000.

Once again there are tears -- but this time from those being bankrupted by the escalating costs of health care.

"Sunset Boulevard," Billy Wilder's 1950 classic, played to a packed park in mid-Manhattan this week. Norma Desmond, the faded star played by Gloria Swanson, would have loved it -- an acre of movie fans adoring her image on a giant silver screen, just a short step from the first-run houses on Broadway.

The theater was Bryant Park, the elegantly restored block behind the New York Public Library. For too long the park was infested by drug dealers, and no place for the unwary. Revived with private donations, it now resembles the Tuileries in Paris -- gravel paths, green chairs and all. Home Box Office, Warner Brothers and the Bryant Park Restoration Corporation are co-sponsors of the film series, which runs for eight more Mondays. Next week it's "King Kong," starting at dusk.

There were at least 2,000 cheering and applauding New Yorkers in the audience for "Sunset Boulevard." The loudspeakers were strong enough to blanket traffic noise from 42d Street, and were it not for the surrounding skyscrapers, it was easy to forget you were in the heart of a crowded city.

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A version of this editorial appears in print on August 6, 1993, on Page A00028 of the National edition with the headline: Topics of The Times; 1.5 Bureaucrats per Patient. Today's Paper|Subscribe